Project Summary/Abstract Universal Adherence is an emerging medical device company dedicated to improving adherence to ocular medications through innovative technical solutions. Our proposed Devers Drop Device (D3) will accurately track when a patient removes an eye drop bottle cap, communicate usage data wirelessly to a database that researchers can access, and send alerts to patients when a medication is due. Significant loss of vision-related quality of life can occur when patients do not adhere to their prescribed eye drop medications. We hypothesize that a device that tracks eye drop usage and sends dosage alerts will improve medication adherence, which would be a tremendous benefit to patients suffering from ocular diseases such as glaucoma. Vision loss from glaucoma is preventable with medication but accurate adherence to eye drops is often poor among patients. In addition to helping patients maintain their dosing schedule, the D3 will also provide adherence information to researchers and eye care providers, which will help to understand poor treatment outcomes and to develop improved treatment strategies. In this Phase I grant application, we are proposing engineering and software improvements to develop the next generation of the D3 device. Prototypes of the device will be produced and used in a small, randomized clinical trial with glaucoma patients to evaluate whether the D3 improves medication adherence and to receive patient feedback on the device. At the end of Phase I funding, we expect to have an unobtrusive, universal device that will accurately track when an eye drop medication is used and alert patients when they miss a dose. The device will be marketed to researchers and clinicians who are interested in studying glaucoma adherence. Results of the Phase I project will help guide the third generation of engineering and software improvements for a Phase II application to develop a device for patients and their families to improve glaucoma self-care. The clinical benefits of our device in improving adherence will initially be assessed and targeted towards glaucoma, but the ability of the device to be attached to all FDA-approved eye drop bottle caps will make this device attractive to all patients that need consistent daily use of eye drops.